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The Annals of Thoracic Surgery, Vol 21, 7-11, Copyright © 1976 by The Society of Thoracic Surgeons

ARTICLES

Quadruple coronary artery bypass grafting

JF Ray 3d, WO Myers, FJ Wenzel, RC Intress, JN Beathard, DJ Kummer, WJ Zirnhelt and RD Sautter

In our last 150 consecutive revascularization operations, 30 patients (20%) have had 4 or more bypass grafts. One patient died after quadruple grafting (mortality, 3%). Twenty-two (75%) of the survivors have been rehabilitated to active work status and 25 (86%) were considered by their cardiologists to have improved function postoperatively by New York Heart Association criteria. Preoperatively 15 patients (50% of the group) had either a markedly diminished ejection fraction (EF) or extreme elevation in left ventricular end- diastolic pressure (LVEDP) or both. Complete revascularization, with resection of ventricular aneurysms when present, can be carried out successfully in a high-risk group of patients. Elevated LVEDP or diminished EF per se is not a valid contraindication to myocardial revascularization.